Negative illness perceptions are related to more fatigue among haematological cancer survivors: a PROFILES study

Abstract

Objectives: The common sense model provides a theoretical framework for understanding substantial fatigue among (haematological) cancer survivors based on their illness perceptions. We therefore examined the associations between modifiable illness perceptions and substantial fatigue while controlling for sociodemographic, clinical, and psychological factors (symptoms of depression and anxiety) among haematological cancer survivors. Methods: Data from the population-based PROFILES registry were used. Survivors diagnosed between 1999 and 2013 with Hodgkin lymphoma (N ¼ 164), non-Hodgkin lymphoma (N ¼ 655) and chronic lymphocytic leukaemia (N ¼ 174) were included. Survivors completed the Brief Illness Perception Questionnaire (B-IPQ), the Fatigue Assessment Scale (FAS), and Hospital Anxiety and Depression Scale (HADS). Multivariable logistic regressions analyses were performed for the total group and three haematological cancers separately relating illness perceptions to substantial fatigue (>21 FAS). Results: Haematological cancer survivors with illness perceptions that represent more negative consequences (consequences, OR ¼ 1.27; 95%CI ¼ 1.13-1.42); attribute more symptoms to their illness (identity, OR ¼ 1.29; 95%CI ¼ 1.17-1.43); and have a poorer illness understanding (coherence, 1.13; 1.04-1.22) were more often substantially fatigued. For the remaining five illness perceptions, no significant association was found. Non-Hodgkin lymphoma survivors who reported a poor illness understanding (coherence, OR ¼ 1.35; 95% CI ¼ 1.06-1.72) and chronic lymphocytic leukaemia survivors who reported that treatment can control (OR ¼ 1.25; 95%CI ¼ 1.01-1.55) the illness experienced more often substantial fatigue. Conclusion: Those who experience more consequences of their disease, attribute more symptoms to their illness, and have a poorer illness understanding, have a higher risk to experience substantial levels of fatigue even years after diagnosis. Psychological interventions changing these illness perceptions may be beneficial in reducing fatigue among haematological cancer survivors.

Persistent somatic symptoms are key to individual illness perception at one year after COVID-19

“…In particular, we identified fatigue as a strong covariate of overall illness perception scoring after COVID-19 and as an important factor characterizing individuals with high levels of COVID-19-related concerns, emotional representation and consequences in clustering analysis. Similar effects of chronic fatigue were described in arthritis (12) and hematological malignancy (44). Both acute COVID-19 and its post-acute sequelae encompass various respiratory symptoms such as cough or dyspnea (1,2,4,7).…”

Quality of life of survivors 1 year after the diagnosis of diffuse large B-cell lymphoma: a LYSA study

“…Health-related quality of life (HRQoL) is a multidimensional concept that covers the subjective perceptions of the positive and negative aspects of cancer patients' symptoms, including physical, emotional, social, and cognitive functions, disease symptoms, and side effects of treatment [7]. With chemotherapy treatments, patients may report more anxiety and depression compared to a normative population [8,9], high levels of psychological distress [10], decreased physical and emotional well-being [11], more fatigue [9,10,12,13], sleep problems [10], and lower HRQoL [9]. NHL chemotherapy-specific toxicities include neuropathy [14], cardiotoxicity, and secondary cancers [6].…”

Persistent symptoms of fatigue, neuropathy and role‐functioning impairment among indolent non‐Hodgkin lymphoma survivors: A longitudinal PROFILES registry study

“…This will not only improve early detection but will also enable us to develop tailored supportive care and treatment strategies for those in need (e.g. focused on modifiable lifestyle factors or coping mechanisms) 27,54–56 . Additionally, it might also lead to improved symptom monitoring and better expectation management, which can help patients in making informed treatment decisions with their haematologist 25–27 …”

“…focused on modifiable lifestyle factors or coping mechanisms). 27,[54][55][56] Additionally, it might also lead to improved symptom monitoring and better expectation management, which can help patients in making informed treatment decisions with their haematologist. [25][26][27] In conclusion, up to 10 years after diagnosis, patients with iNHL report a substantially lower HRQoL compared with an age-and sex-matched normative population.…”